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Pyelectasia

Sonopath Forum

– 9 yr FS Miniature Schnauzer with intermittent hematuria
– referring vet performed urine culture on free flow urine (which I don’t recommend) positive for bacteria and sensitive to Clavamox
– they did see calcium oxlate crystals on urine sediment but I don’t no how old the sample was (can form when urine sits to long)
– x-ray showed no evidence of stones in UB or kidneys
– ultrasound showed normal UB; kidneys normal size
– pyelectasia (mild) noted in both kidneys
– ureters not identified

– 9 yr FS Miniature Schnauzer with intermittent hematuria
– referring vet performed urine culture on free flow urine (which I don’t recommend) positive for bacteria and sensitive to Clavamox
– they did see calcium oxlate crystals on urine sediment but I don’t no how old the sample was (can form when urine sits to long)
– x-ray showed no evidence of stones in UB or kidneys
– ultrasound showed normal UB; kidneys normal size
– pyelectasia (mild) noted in both kidneys
– ureters not identified
So, differentials: pyelonephritis, small renoliths (maybe seen in right kidney but not left), diuresis (PU/PD disease)

I will sometimes see mild pyelectasia is patients that have no history of kidney disease when scanning for other things. I think I read somewhere >2mm dilation is pathologic. What degree of pyelectasia would you consider worrisome?

Comments

Anonymous

I never like pyelectasia in
I never like pyelectasia in light of anything inflammatory ion the urine. but unless its wide enough to get a 25g needle in it and culture its tough to know whats causing it. I think scarring can do it as well especially if stones are around as they move sooner or later and cause damage. But if no stones and cysto has bacteria in it (need to check on this one) or + cultures especially if you do them in house then I am thinking pyelo especially if the pelvic fat is not curvilinear and is ill defined that would suggest inflammation.

There was a JVIM article a while back on higher sensitivity of pyelocentesis cultures, i think in cats, as opposed to bladder/cysto cultures so i think that plays a role in this as well. We don’t want to shotgun ABs at everything but we all know how many UTI signs go away when good urinary ABs are given in a case with negative culture. Remo you have this article handy?

Anonymous

I never like pyelectasia in
I never like pyelectasia in light of anything inflammatory ion the urine. but unless its wide enough to get a 25g needle in it and culture its tough to know whats causing it. I think scarring can do it as well especially if stones are around as they move sooner or later and cause damage. But if no stones and cysto has bacteria in it (need to check on this one) or + cultures especially if you do them in house then I am thinking pyelo especially if the pelvic fat is not curvilinear and is ill defined that would suggest inflammation.

There was a JVIM article a while back on higher sensitivity of pyelocentesis cultures, i think in cats, as opposed to bladder/cysto cultures so i think that plays a role in this as well. We don’t want to shotgun ABs at everything but we all know how many UTI signs go away when good urinary ABs are given in a case with negative culture. Remo you have this article handy?

Anonymous

As mentioned in a prior post
As mentioned in a prior post you can get pyelectasia if the patient is on fluids and/or diuretics. However, if there is an active urine sediment then it is most likely significant and treatment should be based on urine culture and sensitivity.

Cannot find a reference to the article that Eric is referring to but makes sense to sample from the affected site and obtaining a urine sample from the pelvis fairly straight forward provided you have adequate patient restraint and the pelvis is large enough to get the needle into it.

Anonymous

As mentioned in a prior post
As mentioned in a prior post you can get pyelectasia if the patient is on fluids and/or diuretics. However, if there is an active urine sediment then it is most likely significant and treatment should be based on urine culture and sensitivity.

Cannot find a reference to the article that Eric is referring to but makes sense to sample from the affected site and obtaining a urine sample from the pelvis fairly straight forward provided you have adequate patient restraint and the pelvis is large enough to get the needle into it.

Anonymous

Can PU/PD cause renal pelvic
Can PU/PD cause renal pelvic dilation detected on ultrasound (ex. Cushings, diabetics)?

Anonymous

Can PU/PD cause renal pelvic
Can PU/PD cause renal pelvic dilation detected on ultrasound (ex. Cushings, diabetics)?

Anonymous

Possibly yes, but have not
Possibly yes, but have not seen any reference to it.

Anonymous

Possibly yes, but have not
Possibly yes, but have not seen any reference to it.

Anonymous

Neither do I but I have
Neither do I but I have suspected it. I’ll look for that ref

Anonymous

Neither do I but I have
Neither do I but I have suspected it. I’ll look for that ref

Anonymous

thx doug found these from
thx doug found these from Viktor at Utrecht but the one i was thinking was from our own Fern Delaney

Ultrasound-guided percutaneous drainage for treatment of pyonephrosis in two dogs
Viktor Szatmári, DVM; Zsófia Ösi, DVM; Ferenc Manczur, DVM, PhD

Pyelography in Cats: The Sonographer’s Role
Fern Ann Delaney, RDMS
University of Wisconsin-Madison Veterinary Medical Teaching Hospital, Madison, WI, USA, delaneyf@svm.vetmed.wisc.edu
Sophie Dennison, BVM&S DACVR
University of Wisconsin-Madison Veterinary Medical Teaching Hospital, Madison, WI, USA
Abstract

Cats are commonly afflicted with chronic renal dysfunction and ureteral obstruction. Concurrent disease can be catastrophic. Sonography-guided pyelocentesis and pyelography provide a method of evaluating potential ureteral obstruction without relying on renal excretory function but are technically demanding. The methodology for these procedures is described in detail to aid the sonographer faced with assisting in this challenge.

Anonymous

thx doug found these from
thx doug found these from Viktor at Utrecht but the one i was thinking was from our own Fern Delaney

Ultrasound-guided percutaneous drainage for treatment of pyonephrosis in two dogs
Viktor Szatmári, DVM; Zsófia Ösi, DVM; Ferenc Manczur, DVM, PhD

Pyelography in Cats: The Sonographer’s Role
Fern Ann Delaney, RDMS
University of Wisconsin-Madison Veterinary Medical Teaching Hospital, Madison, WI, USA, delaneyf@svm.vetmed.wisc.edu
Sophie Dennison, BVM&S DACVR
University of Wisconsin-Madison Veterinary Medical Teaching Hospital, Madison, WI, USA
Abstract

Cats are commonly afflicted with chronic renal dysfunction and ureteral obstruction. Concurrent disease can be catastrophic. Sonography-guided pyelocentesis and pyelography provide a method of evaluating potential ureteral obstruction without relying on renal excretory function but are technically demanding. The methodology for these procedures is described in detail to aid the sonographer faced with assisting in this challenge.